Unilateral hemorrhagic maculopathy: An uncommon manifestation of hand, foot, and mouth disease

Tandon, Manish; Gupta, Abhishek; Singh, Priyanka; Subathra, Gnanavelu N

doi:10.4103/0301-4738.195014

Cited by 5 publications

(1 citation statement)

References 10 publications

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“…8,9 Maculopathy can present many different manifestations, in particular unilateral alterations of RPE associated with irregularities in the ellipsoide zone, retinal vasculitis, unilateral hemorrhagic maculopathy, unilateral retinal exudates, or anterior segment deposits. 7,10,11 Maculopathy is usually self-limited, but scars of the outer layer of the retina with subfoveal ellipsoid zone disruption can occur, with a permanent visual impairment. In our case, in presence of ocular severe conditions, we decided to perform oral prednisolone therapy according to Agrawal et al 7 in order to reduce the inflammatory response.…”

Section: Introductionmentioning

confidence: 99%

Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report

Talli

Bendo

Pedrotti

et al. 2020

European Journal of Ophthalmology

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Purpose: To report the case of a 33-year old man who disclosed the first case of bilateral ocular involvement of hand, foot, and mouth disease (HFMD) with a different stage of the disease in each eye. Methods: Retrospective case report. Results: The study included a patient who incurred in a bilateral HFMD maculopathy. During 6 months follow-up period persistent abnormalities in fundus examination and in OCT scans were reported. Conclusion: We consider that our case shows that choriocapillaris is the primary target of HFMD maculopathy, for this reason we consider that ICGA is mandatory for early diagnosis and an effective treatment.

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Section: Introductionmentioning

confidence: 99%

Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report

Talli

Bendo

Pedrotti

et al. 2020

European Journal of Ophthalmology

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Bilateral idiopathic retinal vasculitis following coxsackievirus A4 infection: a case report

et al. 2017

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BackgroundCoxsackieviruses are members of a group of viruses called the enteroviruses, which may cause respiratory and gastrointestinal symptoms, erythema, meningoencephalitis, myocarditis, pericarditis, and myositis. Unilateral acute idiopathic maculopathy caused by coxsackievirus A16 has been associated with hand, foot, and mouth disease, but only a few reports describe retinitis associated with coxsackievirus serotype B3 or B4. We report a case of bilateral multifocal obstructive retinal vasculitis that developed after coxsackievirus A4 infection.Case presentationA 60-year-old woman was referred to our department with bilateral visual disturbance that developed following flu-like symptoms. At the initial examination, best corrected visual acuity was 20/200 in the right eye and 20/50 in the left eye. The critical flicker frequency (CFF) was 23 Hz in the right eye and 27 Hz in the left eye. Fine white keratic precipitates with infiltrating cells were presented in the anterior chamber of both eyes, and multifocal retinal ischemic lesions were observed in the macula and posterior pole of both eyes. The retinal lesions corresponded with scotomas observed in Goldmann visual field test. On spectral domain-optical coherence tomography (SD-OCT), retinal lesions were depicted as hyper-reflective regions in the inner retina layers in both eyes, and disruption of ellipsoid line in the left eye., Fluorescein angiography exhibited findings indicative of multifocal obstructive retinal vasculitis. The patient had a history of current hypertension treated with oral therapy and glaucoma treated with latanoprost eye drops. Blood test for coxsackievirus antibody titers revealed that A4, A6, A9, B1, B2, B3, and B5 were positive (titers: 8–32). Abdominal skin biopsy of necrotic tissue suggested vascular damage caused by coxsackievirus. The general symptoms improved after 6 weeks, and the multifocal retinal ischemic lesions were partially resolved with residual slightly hard exudates. Only coxsackievirus A4 antibody titer increased from 4 to 32-fold after 14 months. However, hyper-reflective regions and disruption of the inner retinal layers on SD-OCT persisted especially in the right eye, and residual paracentral scotoma was observed in the right eye.ConclusionThe present case suggests that coxsackievirus A4 causes bilateral multifocal obstructive retinal vasculitis with irreversible inner retinal damage.

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Pseudomembranous conjunctivitis with hand, foot and mouth disease in a pregnant woman : a case report

Kim

2021

BMC Ophthalmol

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Background Hand, foot, and mouth disease (HFMD) is a common systemic infection that is caused by an enterovirus, normally Coxsackie A16. Generally, it affects children or immunocompromised adults. Only a few reports have described pseudomembranous conjunctivitis associated with HFMD. We aim to describe the clinical outcomes and ocular findings of a 37-year-old female with HFMD and concurrent severe pseudomembranous conjunctivitis, who was 28 weeks pregnant. Case presentation A female patient who was 28-weeks pregnant was referred for an ophthalmological review due to pain and injection in both eyes. The patient was hospitalized under obstetrics and gynecology and evaluated for Behcet’s disease with oral and perineal ulcers. In an ophthalmic examination, both eyes were observed to have a conjunctival injection. Behcet’s disease-associated conjunctivitis was diagnosed. Topical steroids and antibiotics were administered every 6 h. Two days after her presentation, a maculopapular eruption occurred on her palms. Enterovirus type 71 was detected in a serum virus antibody test, and the patient was diagnosed with HFMD. After 7 days, severe pseudomembranous conjunctivitis and corneal epithelial defects occurred in both eyes. Topical steroids were administered every 3 h, and the pseudomembrane was removed every 2 to 3 days. The pseudomembrane did not occur after 3 weeks, but corneal erosion persisted. After 3 months, the corneal erosion had completely resolved. Conclusions HFMD-associated conjunctivitis is a rare complication in adults, however it can appear as a severe pseudomembranous conjunctivitis. In this case, the removal of the pseudomembrane and topical steroids helped improve the symptoms.

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Unilateral hemorrhagic maculopathy: An uncommon manifestation of hand, foot, and mouth disease

Cited by 5 publications

References 10 publications

Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report

Is choriocapillaris the early target in acute maculopathy secondary to hand, foot, and mouth disease? A case report

Bilateral idiopathic retinal vasculitis following coxsackievirus A4 infection: a case report

Pseudomembranous conjunctivitis with hand, foot and mouth disease in a pregnant woman : a case report

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